Sr. Claim Specialist, Workman's Compensation

Company: Zurich 56 Company Ltd
Location: Boston
Posted on: April 1, 2025

Job Description:

Sr. Claim Specialist, Workman's CompensationZurich North America is seeking an experienced Senior Claims Specialist in Workers' Compensation to join our team.At Zurich North America Claims, we acknowledge that work-life balance and flexibility are a priority when it comes to choosing your next career move. Designed with our employees' needs in mind, the ZNA Claims hybrid work model emphasizes flexibility, allowing claims employees to conduct individual work in their preferred location, while facilitating in-person connections and collaborative activities when meaningful and valuable. This position can be either a hybrid position in our Parsippany, NJ or Boston, MA offices, or fully remote for candidates who do not live near our physical offices. We are seeking applicants with experience in handling Workers' Compensation claims for PA, VA, DC, and DE.The Senior Workers' Compensation Claims Specialist will manage workers' compensation claims of moderate to high exposure and complexity, within defined authority limits. This role focuses on ensuring claims are handled efficiently and effectively, with an emphasis on delivering exceptional, customer-centric service.In this role, you will be responsible for:

• Documenting claims files by accurately capturing and updating claims data and information, ensuring compliance with best practices for commercial claims of moderate to high exposure and complexity.
• Exercising sound judgment to determine liability by gathering and analyzing relevant facts, applying applicable law, and establishing basic principles of negligence.
• Conducting policy verification and making coverage determinations by analyzing applicable coverage for claims and assessing if the loss falls within the policy's terms.
• Driving timely claims resolutions by developing case strategies, performing case evaluations, and escalating issues as appropriate.
• Setting and reviewing reserves promptly throughout the claims cycle within authority limits, including estimating and validating claim values.
• Assessing damages by calculating applicable damages or the range permitted by law.
• Negotiating claim settlements by establishing an effective negotiation strategy and using available tools and resources within authority limits.
• Meeting quality standards by adhering to established best practices.Basic Qualifications:
  • Bachelor's Degree and 6 or more years of experience in the Claims and/or Litigation Management area.OR
  • Juris Doctor and 2 or more years of experience in the Claims and/or Litigation Management area.OR
  • Zurich Certified Insurance Apprentice, including an Associate Degree with 6 or more years of experience in the Claims and/or Litigation Management area.OR
  • Completion of Zurich Claims Training Program and 6 or more years of experience in the Claims and/or Litigation Management area.OR
  • High School Diploma Equivalent and 8 or more years of experience in the Claims and/or Litigation Management area.AND
  • Must obtain and maintain required adjuster license(s)
  • Knowledge of insurance regulations, markets, and productsPreferred Qualifications:
    • 8+ years of experience handling Workers Compensation claims with high severity and exposure.
    • 8+ years of experience in Litigation Management.
    • Jurisdictional expertise and experience working in the states of PA, VA, DC and/or DE.
    • Effective verbal and written communication skills.
    • Strong analytical, critical thinking, and problem-solving skills.
    • Strong multi-tasking and prioritization skills.
    • Experience collaborating in a team environment and building cross-functional working relationships.
    • Proactively shares and promotes sharing of insights.
    • Ability to gather unique perspectives from other teams/functions to optimize outcomes.
    • Understands, analyzes, and applies the component parts of an insurance policy for complex claims.
    • Ability to follow reserving process for indemnity and expense in analyzing the potential exposure of complex claims.
    • Ability to determine the scope and exposure for complex claims.
    • Ability to leverage trend and relationships to provide high-quality customer service.
    • Well-versed in identifying, understanding, and explaining complex financial and/or actuarial trends/concepts.
    • Ability to effectively communicate coverage determinations to customers/clients/brokers for complex claims.
    • Ability to direct counsel on an ongoing basis to guide the course of complex litigation and settlement strategies.At Zurich, compensation for roles is influenced by a variety of factors, including but not limited to the specific office location, role, skill set, and level of experience. In compliance with local laws, Zurich commits to providing a fair and reasonable compensation range for each role. The proposed salary range for this position is $74,300.00 - $121,700.00, with short-term incentive bonus eligibility set at 15%.As a global company, Zurich recognizes the diversity of our workforce as an asset. We recruit talented people from a variety of backgrounds with unique perspectives that are truly welcome here. Zurich does not discriminate on the basis of age, race, ethnicity, color, religion, sex, sexual orientation, gender expression, national origin, disability, protected veteran status or any other legally protected status. EOE disability/vetLocation(s): AM - Pennsylvania Virtual Office, AM - Parsippany, AM - BostonRemote Working: HybridSchedule: Full TimeEmployment Sponsorship Offered: No
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Keywords: Zurich 56 Company Ltd, Boston , Sr. Claim Specialist, Workman's Compensation, Other , Boston, Massachusetts